diabetestalk.net

How Do You Diagnose Gestational Diabetes

Gestational Diabetes

Gestational Diabetes

What Is Gestational Diabetes? Gestational diabetes sometimes develops when a woman is pregnant. It’s when the blood glucose level (blood sugar level) of the mother goes too high during pregnancy. Having an elevated blood glucose level during pregnancy can cause problems for your baby—if it’s left untreated. Fortunately, doctors are vigilant about checking for gestational diabetes so that it can be identified and effectively managed. A pro-active treatment plan helps you have a good pregnancy and protects the health of your baby. Gestational Diabetes Symptoms Gestational diabetes doesn’t often cause noticeable symptoms for the mother. Other types of diabetes (eg, type 1 diabetes or type 2 diabetes) do cause symptoms such as increased thirst, but that is hardly ever noticed in gestational diabetes. Because there aren’t often symptoms, it’s very important to be tested for a high blood glucose level when you’re pregnant. (Your doctor will most likely test you for gestational diabetes sometime between the 24th and 28th week. You can learn more about the diagnostic process here.) Then your doctor will know if you need to be treated for gestational diabetes. Gestational Diabetes Causes and Risk Factors Gestational diabetes develops when your body isn’t able to produce enough of the hormone insulin during pregnancy. Insulin is necessary to transport glucose—what your body uses for energy—into the cells. Without enough insulin, you can build up too much glucose in your blood, leading to a higher-than-normal blood glucose level and perhaps gestational diabetes. The elevated blood glucose level in gestational diabetes is caused by hormones released by the placenta during pregnancy. The placenta produces a hormone called the human placental lactogen (HPL), also Continue reading >>

Pregnancy And Gestational Diabetes Screening

Pregnancy And Gestational Diabetes Screening

All pregnant women should be screened for gestational diabetes during their pregnancy. Screening may be done by taking the woman's medical history and examining certain risk factors, but an oral glucose tolerance test is also recommended. The oral glucose tolerance test is used to screen for gestational diabetes. Gestational diabetes is a specific type of diabetes that can develop in some women late in pregnancy (usually after the 24th week). Women who develop this complication do not have diabetes before becoming pregnant. The test is generally given between the 24th and 28th week of pregnancy. If you have had gestational diabetes before, or if your health care provider is concerned about your risk of developing gestational diabetes, the test may be performed before the 13th week of pregnancy. The oral glucose tolerance test involves quickly drinking a sweetened liquid (called Glucola), which contains 50g of glucose. The body absorbs this glucose rapidly, causing blood glucose levels to rise within 30 to 60 minutes. A blood sample will be taken from a vein in your arm about 60 minutes after drinking the solution. The blood test measures how the glucose solution was metabolized (processed by the body). A blood glucose level of 140mg/dL or higher will identify 80% of women with gestational diabetes. When that cutoff is lowered to 130mg/dL, the identification increases to 90%. If your blood glucose level was greater than 130 mg/dL, your provider will likely recommend you take another diabetes screening test that requires you to fast (not eat anything) before the test. During this second test, called the 100-gram oral glucose tolerance test, your blood glucose level will be tested four times during a three-hour period after drinking the sweetened (many flavors are availabl Continue reading >>

Diagnosis And Management Of Gestational Diabetes Mellitus

Diagnosis And Management Of Gestational Diabetes Mellitus

Gestational diabetes occurs in 5 to 9 percent of pregnancies in the United States and is growing in prevalence. It is a controversial entity, with conflicting guidelines and treatment protocols. Recent studies show that diagnosis and management of this disorder have beneficial effects on maternal and neonatal outcomes, including reduced rates of shoulder dystocia, fractures, nerve palsies, and neonatal hypoglycemia. Diagnosis is made using a sequential model of universal screening with a 50-g one-hour glucose challenge test, followed by a diagnostic 100-g three-hour oral glucose tolerance test for women with a positive screening test. Treatment consists of glucose monitoring, dietary modification, exercise, and, when necessary, pharmacotherapy to maintain euglycemia. Insulin therapy is the mainstay of treatment, although glyburide and metformin may become more widely used. In women receiving pharmacotherapy, antenatal testing with nonstress tests and amniotic fluid indices beginning in the third trimester is generally used to monitor fetal well-being. The method and timing of delivery are controversial. Women with gestational diabetes are at high risk of subsequent development of type 2 diabetes. Lifestyle modification should therefore be encouraged, along with regular screening for diabetes. Evidence for screening, diagnosing, and managing gestational diabetes mellitus has continued to accrue over the past several years. In 2003, the U.S. Preventive Services Task Force1 (USPSTF) and the Cochrane Collaboration2 found insufficient evidence to recommend for or against screening for or treating gestational diabetes. However, a subsequent randomized controlled trial (RCT) found that screening and intervention for gestational diabetes were beneficial.3 Nonetheless, in 2008, Continue reading >>

Ada Guidelines Diabetes In Pregnancy Gdm | Ndei

Ada Guidelines Diabetes In Pregnancy Gdm | Ndei

Diabetes in pregnancy may increase the risk of obesity and type 2 diabetes in offspring later in life Maintain A1C levels as close to normal as is safely possible Ideally, A1C <6.5% (48 mmol/L) without hypoglycemia Prescribe effective contraception until woman is prepared to become pregnant Women with preexisting type 1 or type 2 diabetes Counsel on the risk of development and/or progression of diabetic retinopathy Perform eye exams before pregnancy or in first trimester; monitor every trimester and for 1 year postpartum Insulin is the preferred medication for pregestational type 1 and type 2 diabetes not adequately controlled with diet, exercise, and metformin Insulin* management during pregnancy is complex Requires frequent titration to match changing requirements Referral to specialized center recommended Women with type 1 diabetes are at high risk for hypoglycemia Hypoglycemia education important before and during pregnancy to prevent hypoglycemia Women with type 1 diabetes are at risk for ketoacidosis At lower blood glucose levels than in the nonpregnant state Provide education on prevention and treatment of diabetic ketoacidosis Women with type 2 diabetes are at risk for obesity Recommended weight gain during pregnancy: 15-25 lb overweight, 10-20 lb obese Glycemic control easier to achieve than in type 1 but can require higher insulin doses 1-hr postprandial 130-140 mg/dL (7.2-7.8 mmol/L) *Most insulins are category B; glargine, glulisine, and degludec are category C Recommendations for Gestational Diabetes Mellitus (GDM) GDM increases the risk of macrosomia, birth complications, and maternal diabetes after pregnancy Risks increase with progressive hyperglycemia Risk may be reduced with diet, physical activity, and lifestyle counseling Medical nutrition, physical Continue reading >>

Who Recommendation On The Diagnosis Of Gestational Diabetes In Pregnancy

Who Recommendation On The Diagnosis Of Gestational Diabetes In Pregnancy

Home > RHL Topics > Preconception, pregnancy, childbirth and postpartum care > Antenatal care > WHO recommendation on the diagnosis of gestational diabetes in pregnancy WHO recommendation on the diagnosis of gestational diabetes in pregnancy WHO recommendation on the diagnosis of gestational diabetes in pregnancy Hyperglycaemia first detected at any time during pregnancy should be classified as either gestational diabetes mellitus (GDM) or diabetes mellitus in pregnancy, according to WHO criteria. This recommendation has been integrated from the 2013 WHO publication Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy (the strength of the recommendation and the quality of the evidence were not stated) (1), which states that GDM should be diagnosed at any time in pregnancy if one or more of the following criteria are met: fasting plasma glucose 5.16.9 mmol/L (92125 mg/dL) 1-hour plasma glucose 10.0 mmol/L (180 mg/dL) following a 75 g oral glucose load 2-hour plasma glucose 8.511.0 mmol/L (153199 mg/dL) following a 75 g oral glucose load Diabetes mellitus in pregnancy should be diagnosed if one or more of the following criteria are met: fasting plasma glucose 7.0 mmol/L (126 mg/dL) 2-hour plasma glucose 11.1 mmol/L (200 mg/dL) following a 75 g oral glucose load random plasma glucose 11.1 mmol/L (200 mg/dL) in the presence of diabetes symptoms. WHO currently does not have a recommendation on whether or how to screen for GDM, and screening strategies for GDM are considered a priority area for research, particularly in LMICs. Diabetes mellitus in pregnancy differs from GDM in that the hyperglycaemia is more severe and does not resolve after pregnancy as it does with GDM. A systematic review of cohort studies shows that women with hyperglycaem Continue reading >>

Diagnosis

Diagnosis

Print Medical experts haven't agreed on a single set of screening guidelines for gestational diabetes. Some question whether gestational diabetes screening is needed if you're younger than 25 and have no risk factors. Others say that screening all pregnant women is the best way to identify all cases of gestational diabetes. When to screen Your doctor will likely evaluate your risk factors for gestational diabetes early in your pregnancy. If you're at high risk of gestational diabetes — for example, your body mass index (BMI) before pregnancy was 30 or higher or you have a mother, father, sibling or child with diabetes — your doctor may test for diabetes at your first prenatal visit. If you're at average risk of gestational diabetes, you'll likely have a screening test during your second trimester — between 24 and 28 weeks of pregnancy. Routine screening for gestational diabetes Initial glucose challenge test. You'll drink a syrupy glucose solution. One hour later, you'll have a blood test to measure your blood sugar level. A blood sugar level below 130 to 140 milligrams per deciliter (mg/dL), or 7.2 to 7.8 millimoles per liter (mmol/L), is usually considered normal on a glucose challenge test, although this may vary by clinic or lab. If your blood sugar level is higher than normal, it only means you have a higher risk of gestational diabetes. You'll need a glucose tolerance test to determine if you have the condition. Follow-up glucose tolerance testing. You'll fast overnight, then have your blood sugar level measured. Then you'll drink another sweet solution — this one containing a higher concentration of glucose — and your blood sugar level will be checked every hour for three hours. If at least two of the blood sugar readings are higher than normal, you'll Continue reading >>

Diabetes Mellitus In Pregnancy: Screening And Diagnosis

Diabetes Mellitus In Pregnancy: Screening And Diagnosis

INTRODUCTION Pregnancy is accompanied by insulin resistance, mediated primarily by placental secretion of diabetogenic hormones including growth hormone, corticotropin-releasing hormone, placental lactogen, and progesterone. These and other metabolic changes ensure that the fetus has an ample supply of nutrients. (See "Maternal adaptations to pregnancy: Endocrine and metabolic changes".) Gestational diabetes develops during pregnancy in women whose pancreatic function is insufficient to overcome the insulin resistance associated with the pregnant state. Among the main consequences are increased risks of preeclampsia, macrosomia, and cesarean delivery, and their associated morbidities. The approach to screening for and diagnosis of diabetes in pregnant women will be reviewed here. Management and prognosis are discussed separately: Continue reading >>

Gestational Diabetes

Gestational Diabetes

Gestational diabetes definition and facts Risk factors for gestational diabetes include a history of gestational diabetes in a previous pregnancy, There are typically no noticeable signs or symptoms associated with gestational diabetes. Gestational diabetes can cause the fetus to be larger than normal. Delivery of the baby may be more complicated as a result. The baby is also at risk for developing low blood glucose (hypoglycemia) immediately after birth. Following a nutrition plan is the typical treatment for gestational diabetes. Maintaining a healthy weight and following a healthy eating plan may be able to help prevent or minimize the risks of gestational diabetes. Women with gestational diabetes have an increased risk of developing type 2 diabetes after the pregnancy What is gestational diabetes? Gestational diabetes is diabetes, or high blood sugar levels, that develops during pregnancy. It occurs in about 4% of all pregnancies. It is usually diagnosed in the later stages of pregnancy and often occurs in women who have no prior history of diabetes. What causes gestational diabetes? Gestational diabetes is thought to arise because the many changes, hormonal and otherwise, that occur in the body during pregnancy predispose some women to become resistant to insulin. Insulin is a hormone made by specialized cells in the pancreas that allows the body to effectively metabolize glucose for later usage as fuel (energy). When levels of insulin are low, or the body cannot effectively use insulin (i.e., insulin resistance), blood glucose levels rise. What are the screening guidelines for gestational diabetes? All pregnant women should be screened for gestational diabetes during their pregnancy. Most pregnant women are tested between the 24th and 28th weeks of pregnancy (see Continue reading >>

Testing For Gestational Diabetes

Testing For Gestational Diabetes

Your ‘booking appointment’ is your first appointment with your midwife or GP to talk about your pregnancy. This usually happens around 8–12 weeks of pregnancy. During that appointment, the midwife or GP will carry out some routine tests (tests offered to every woman) and ask lots of questions. Some of the questions will help find out if you are at risk of developing gestational diabetes (they will be looking to see if you have any of the risk factors). If you are considered at high risk, you will be offered a test. Agreeing to these tests is important because if you have gestational diabetes, there is a small increased risk of serious birth complications. Finding out if you have it and treating the condition can reduce those risks. The key things you need to know are: If you are at risk of gestational diabetes but don’t take the test, it can’t be found and treated. This may increase the risk to you and your baby. If you are diagnosed with gestational diabetes, you will have more check-ups and extra care during your pregnancy and labour. In some women, gestational diabetes responds to changes in diet and exercise, while others will need to take medication, which may be in the form of tablets or insulin injections. "I wasn’t obviously skinny, but I wasn’t massively obese either… I had no symptoms whatsoever. I had no expectation that the Lucozade test would be anything other than a formality." What if I had gestational diabetes in an earlier pregnancy? If you have had gestational diabetes in a previous pregnancy, you need to take action before you become pregnant again. You need to be scanned for diabetes when you are planning your pregnancy to make sure that your blood glucose levels are safe. You also need to be tested as soon as possible after your book Continue reading >>

Glucose Screening Tests During Pregnancy

Glucose Screening Tests During Pregnancy

TWO-STEP TESTING During the first step, you will have a glucose screening test: You DO NOT need to prepare or change your diet in any way. You will be asked to drink a liquid that contains glucose. Your blood will be drawn 1 hour after you drink the glucose solution to check your blood glucose level. If your blood glucose from the first step is too high, you will need to come back for a 3-hour glucose tolerance test. For this test: DO NOT eat or drink anything (other than sips of water) for 8 to 14 hours before your test. (You also cannot eat during the test.) You will be asked to drink a liquid that contains glucose, 100 grams (g) . You will have blood drawn before you drink the liquid, and again 3 more times every 60 minutes after you drink it. Each time, your blood glucose level will be checked. Allow at least 3 hours for this test. ONE-STEP TESTING You need to go to the lab one time for a 2-hour glucose tolerance test. For this test: DO NOT eat or drink anything (other than sips of water) for 8 to 14 hours before your test. (You also cannot eat during the test.) You will be asked to drink a liquid that contains glucose (75 g). You will have blood drawn before you drink the liquid, and again 2 more times every 60 minutes after you drink it. Each time, your blood glucose level will be checked. Allow at least 2 hours for this test. Continue reading >>

Gestational Diabetes - Symptoms, Diagnosis, Treatment

Gestational Diabetes - Symptoms, Diagnosis, Treatment

Diabetes is diagnosed when a person has too much glucose (sugar) in the blood. Gestational diabetes is a variation of the disease that occurs during pregnancy, and is the result of the mother not being able to produce enough insulin. Gestational diabetes may not present obvious symptoms but may be diagnosed during routine pregnancy screening. The condition can adversely affect the pregnancy and health of the baby but can be managed with diet modification and exercise and, if necessary, medication. General information Diabetes mellitus (commonly known as diabetes) is a group of diseases characterised by high blood glucose levels over a prolonged period of time. This page deals with gestational diabetes. Other variations of diabetes include: Type 1 diabetes – usually diagnosed in childhood or adolescence. Type 2 diabetes – associated with a person being overweight. Gestational diabetes accounts for 90% of cases of diabetes in pregnancy, while pre-existing type 2 diabetes accounts for 8% of such cases. It usually develops during the second half of pregnancy but can occur as early as the 20th week. Gestational diabetes is common, with 3000–4000 women being diagnosed with the condition or its recurrence each year in New Zealand. The prevalence of gestational diabetes is increasing (8–9% per year) and is higher in Māori (5–10%), Pacific peoples (4–8%), and Asian Indians (4%) than in New Zealand Europeans (3%). The increasing rate of gestational diabetes appears to be related to increasing rates of obesity. Causes The exact cause of gestational diabetes is not known. However, pregnancy does affect how the body metabolises (breaks down) glucose. Glucose is absorbed into the bloodstream following a meal. The body then uses insulin (a hormone produced by the pancreas Continue reading >>

Different Strategies For Diagnosing Gestational Diabetes Mellitus (gdm) To Improve Maternal And Infant Health

Different Strategies For Diagnosing Gestational Diabetes Mellitus (gdm) To Improve Maternal And Infant Health

Different strategies for diagnosing gestational diabetes mellitus (GDM) to improve maternal and infant health We aimed to evaluate and compare different ways of diagnosing gestational diabetes mellitus (GDM). We searched for all relevant studies in January 2017. Between seven and 24 pregnant women in every 100 develop GDM. GDM is when there is an inability to process carbohydrates properly, which leads to high blood sugar ( hyperglycaemia ). GDM can result in increased risks of problems around the time of birth for the mother and her baby. Treatment can reduce these risks, and therefore diagnosing the condition accurately means that treatment can be given to improve the health of mothers and their babies. Different testing strategies aim to diagnose GDM. We wanted to compare the different strategies, to see how they affected the health of women and their infants, and to assess the cost of the strategies to the healthcare service. We found seven trials. A total of 1420 women were included, in settings in Turkey, Mexico, Nigeria, New Zealand, Canada and the USA. Across the trials, different testing approaches and criteria were evaluated as were different diagnostic tests including different oral glucose tolerance test loads; a glucose drink; a candy bar and food high in glucose. Women were given these items to eat/drink, and this was then followed by a blood test to measure blood sugar levels and questionnaires. In some tests, women were required to fast from the night before. The main outcomes we looked for were frequency of diagnosis, incidence of caesarean section , assisted birth and vaginal birth, and incidence of macrosomia in babies (larger than normal weight at birth). Other outcomes spanned a range, including any side effects of the tests, the mothers' preferenc Continue reading >>

Gestational Diabetes Test: What To Expect

Gestational Diabetes Test: What To Expect

Gestational diabetes occurs only during pregnancy, and it usually goes away once you’ve delivered your baby. Pregnant women with gestational diabetes have higher than normal blood sugar. This is because their bodies aren’t producing enough insulin. Insulin is a hormone that regulates blood sugar. Gestational diabetes can happen at almost any time during pregnancy, but it typically occurs between 24 to 28 weeks. This is also when testing typically takes place. Getting tested for gestational diabetes is an important part of prenatal care. Doctors test all pregnant women at least once during pregnancy. Your doctor will consider your risk factors when determining when you should have this test and how often you should have it. Learn what to expect during this test and how to prepare. Many women who have gestational diabetes have no symptoms. If symptoms do appear, it’s possible you may overlook them because they’re similar to typical pregnancy symptoms. These symptoms may include: frequent urination extreme thirst fatigue snoring You should call your doctor if you’re experiencing these symptoms to a greater degree than is normal for you. The exact cause of gestational diabetes is unknown, but it may be due to hormones your placenta produces. These hormones help your baby grow, but they can also stop insulin from doing its job. If your body can’t make enough insulin, the sugar in your bloodstream stays put. The sugar is then unable to convert into energy in the cell. This is called insulin resistance. If it’s left untreated, gestational diabetes can have significant consequences for both you and your baby. Once your doctor knows you have this condition, they’ll work with you on a treatment plan to ensure your and your baby’s health. Any pregnant woman can g Continue reading >>

Tests & Diagnosis For Gestational Diabetes

Tests & Diagnosis For Gestational Diabetes

When will I be tested for gestational diabetes? Testing for gestational diabetes usually occurs between 24 and 28 weeks of pregnancy. If you have an increased chance of developing gestational diabetes, your doctor may test for diabetes during the first visit after you become pregnant. How do doctors diagnose gestational diabetes? Doctors use blood tests to diagnose gestational diabetes. You may have the glucose challenge test, the oral glucose tolerance test, or both. These tests show how well your body uses glucose. Glucose Challenge Test You may have the glucose challenge test first. Another name for this blood test is the glucose screening test. In this test, a health care professional will draw your blood 1 hour after you drink a sweet liquid containing glucose. You do not need to fast for this test. Fasting means having nothing to eat or drink except water. If your blood glucose is too high—140 or more—you may need to return for an oral glucose tolerance test while fasting. If your blood glucose is 200 or more, you may have type 2 diabetes. Oral Glucose Tolerance Test (OGTT) The OGTT measures blood glucose after you fast for at least 8 hours. First, a health care professional will draw your blood. Then you will drink the liquid containing glucose. You will need your blood drawn every hour for 2 to 3 hours for a doctor to diagnose gestational diabetes. High blood glucose levels at any two or more blood test times—fasting, 1 hour, 2 hours, or 3 hours—mean you have gestational diabetes. Your health care team will explain what your OGTT results mean. Your health care professional may recommend an OGTT without first having the glucose challenge test. Continue reading >>

What To Expect With Gestational Diabetes

What To Expect With Gestational Diabetes

Blood glucose control is key to having a healthy baby A diagnosis of gestational diabetes can cast a shadow over the joys of pregnancy. While the vast majority of these cases end with a healthy baby and mom, gestational diabetes (high blood glucose during pregnancy in a woman who has never had type 1 or type 2 diabetes) does increase risks to the health of both baby and mother. Keeping blood glucose under control is crucial for women with gestational diabetes to help safeguard their babies and themselves. Gestational diabetes is caused by issues that arise as part of a normal pregnancy: hormonal changes and weight gain. Women whose bodies can't compensate for these changes by producing enough of the hormone insulin, which ushers glucose from the blood into cells to produce energy, develop high blood glucose and gestational diabetes. Overweight mothers are at a greater risk for the condition. In the United States, gestational diabetes is reported in somewhere between 2 and 10 percent of pregnancies, but it is now believed that the condition affects 18 percent of women in pregnancy. The larger number is the result of new criteria for diagnosis, not just skyrocketing rates. The American Diabetes Association began recommending this year that gestational diabetes be diagnosed with only one abnormal test result rather than two, the previous method, and this is causing more cases to be detected. Gestational diabetes usually appears roughly halfway through pregnancy, as the placenta puts out large amounts of "anti-insulin" hormones. Women without known diabetes should be screened for gestational diabetes 24 to 28 weeks into their pregnancies. (If high blood glucose levels are detected earlier in pregnancy, the mother-to-be may actually have type 2 diabetes, rather than gestati Continue reading >>

More in diabetes